^(18)F-FDG PET显像鉴别肺部单发肿块性质及肺癌分期的价值

18 F FDG PET for the identification of solitary pulmonary nodules and staging of lung cancer

为探讨１８Ｆ２脱氧葡萄糖（ＦＤＧ）ＰＥＴ显像在肺部单发肿块（ＳＰＮｓ）性质鉴别和肺癌分期中的价值，对２７例肺癌病人（其中单发癌灶者１１例）和１０例肺部单发良性病变病人进行了１８ＦＦＤＧＰＥＴ显像，用定性法和半定量法进行分析，并与ＣＴ、ＭＲＩ、手术及病理结果进行比较。结果示１１例病理检查证实的恶性ＳＰＮｓ病人肺部均可见局部高ＦＤＧ浓集区，单位重量组织ＦＤＧ摄取量与单位体重ＦＤＧ注射量比值（ＳＵＶ）为５７２±２２３，病变与其周围正常组织ＦＤＧ摄取比值（Ｌ／ＮＵＲ）为４２２±２５７；１６例肺部多发癌灶者局部ＦＤＧ摄取也明显增高（ＳＵＶ为５９４±２８６，Ｌ／ＮＵＲ为４５７±２１０）；１０例良性ＳＰＮｓ中除１例活动期肺结核外，余９例均未见高ＦＤＧ浓集区（ＳＵＶ为０９２±０３６，Ｌ／ＮＵＲ为０８３±０２７），良恶性病变间差异有显著性（ｔ＝４１５～６８８，Ｐ均＜００１）。９例经手术治疗的肺癌病人，术前ＰＥＴ分期结果均与手术分期一致，ＣＴ或ＭＲＩ仅６例与手术分期结果一致。ＰＥＴ还在１１例病人中发现了１７个ＣＴ或ＭＲＩ未能发现的转移灶。结果表明，１８ＦＦＤＧＰＥＴ显像是鉴别肺部单发肿块性?

PURPOSE To evaluate 18 F FDG PET for the identification of solitary pulmonary nodules (SPNs) and staging of lung cancer METHODS 18 F FDG PET was performed in 27 patients with lung cancer (including 11 malignant SPNs) and 10 patients with benign SPNs Results were correlated with other imaging techniques, pathology and operation RESULTS 18 F FDG PET demonstrated increased FDG uptake in 11 histology proved malignant SPNs patients ±s, SUV (specific activity Bq/g in ROI/injected dose Bq per body weight) 5 72±2 23, L/N UR (lesion/normal tissue uptake rate) 4 22±2 57 and 16 non SPNs lung cancer patients (±s, SUV 5 94±2 86, L/N UR 4 57±2 10), whereas no focal increased FDG uptake was seen in 9 patients with benign SPNs except one patient with tuberculosis (±s, SUV 0 92±0 36, L/N UR 0 83±0 27, t=4 15～6 88,P<0 01) In staging of lung cancer 9 patients had the same result of 18 F FDG PET compared with operation whereas only 6 in CT and MRI Besides, PET discovered 17 new metastatic lesions not found by CT or MRI in 11 patients CONCLUSIONS 18 F FDG PET was a reliable and useful method for identification of SPNs and staging of lung cancer, and was more accurate than CT and MRI